Description
Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Clinical Nurse Auditor, HEDIS who will:
Be responsible for conducting clinical quality audits for the Quality Department.
Identify and coordinate clinical audits to determine potential areas for quality improvement within the PHP network.
Collect data by way of chart extraction, using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program.
Conduct audits, which include review of outpatient medical records, hospital records, clinical lab and pharmacy records.
Be responsible for collecting data based on standardized methodologies.
Organize data to identify and address opportunities for improvement.
Perform chart audits electronically or on site in physician practices during the audit season.
Successfully complete HEDIS training prior to performing chart abstractions.
Maintain all collected records in a confidential manner.
Perform all duties in a manner which promotes team concept and reflects the Providence Health Plan's mission and philosophy.
Communicate in a collaborative manner with the team in a way that represents Providence Health Plan.
Please note the following important detail regarding this HEDIS Seasonal Role:
This posting is for multiple openings of a Nurse Auditor, HEDIS.
This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon.
Position Type: Temporary, Per Diem, Non Benefitted.
Length of Program Anticipated to last between: January 2025 - May 2025.
Work Schedule: Monday - Friday.
Work Hours Scheduled Weekly: 40.
This position will require a full-time commitment to the project, meaning no extended time off during the HEDIS Season (January 2025 - May 2025).
Providence Health Plan welcomes remote work for applicants who reside in:
Required qualifications for this position include:
Preferred qualifications for this position include:
Bachelor's Degree in Nursing.
Dual RN License: Oregon and Washington.
1+ years' experience in Quality Management, Quality Improvement, Utilization Review Auditing.
1+ years' experience auditing electronic health records.
Experience with health plans, project management, program evaluation, team facilitation, data analysis and or case review.
Experience working as a Nurse supporting a minimum of one HEDIS Audit season.
Why Join Providence Health Plan?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Requisition ID: 325315
Company: Providence Jobs
Job Category: Nursing-Patient Facing
Job Function: Nursing
Job Schedule: Part time
Job Shift:
Career Track: Nursing
Department: 5018 HCS QUALITY MANAGEMENT OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Workplace Type: Remote
Pay Range: $40.20 - $63.64
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